Tirofiban

Tirofiban is a prescription medication used to treat Non-ST Elevated Acute Coronary Syndrome (NSTE-ACS). 

• Tirofiban is available under the following different brand names: Aggrastat. 

Adult dosage

Premixed IV infusion solution

• 5mg/100mL (50mcg/mL)
• 12.5mg/250mL (50mcg/mL)

IV solution vials

• 5mg/100mL vial (50mcg/mL)
• 3.75mg/15mL bolus vial (250mcg/mL)

Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS)

Adult dosage

• Loading dose: 25 mcg/kg IV infused within 5 minutes, then
• Post loading dose infusion: 0.15 mcg/kg/min IV for up to 18 hours

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Tirofiban include:

• dizziness, 
• slow heart rate, 
• leg pain, 
• pelvic pain, 
• swelling, and 
• increased sweating

Serious side effects of Tirofiban include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• easy bruising, 
• unusual bleeding (nosebleeds, bleeding gums), 
• bleeding around the injection site, 
• bloody or tarry stools, 
• coughing up blood, 
• vomit that looks like coffee grounds, and
• any bleeding that will not stop

Rare side effects of Tirofiban include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Tirofiban has severe interactions with no other drugs.
• Tirofiban has serious interactions with at least 12 other drugs. 
• Tirofiban has moderate interactions with at least 22 other drugs. 
• Tirofiban has minor interactions with the following drugs:
  • devil’s claw, 
  • ginger, 
  • ginkgo biloba, 
  • horse chestnut seed, 
  • levothyroxine, 
  • verteporfin

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Severe hypersensitivity reaction to the drug (i.e., anaphylactic reactions) or excipients.
• History of thrombocytopenia following prior exposure to therapy. 
• Active internal bleeding or history of bleeding diathesis, major surgical procedure or severe physical trauma within the previous month.

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Tirofiban?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Tirofiban?”

Cautions

• Bleeding is most common complication encountered during therapy; most bleeding associated with therapy occurs at arterial access site for cardiac catheterization; minimize use of traumatic or potentially traumatic procedures such as arterial and venous punctures, intramuscular injections, nasotracheal intubation, etc.
• Concomitant use of fibrinolytics, anticoagulants and antiplatelet drugs increases risk of bleeding
• Profound thrombocytopenia reported; monitor platelet counts beginning about 6 hr after treatment initiation and daily thereafter; If platelet count decreases to less than 90,000/mm3, monitor platelet counts to exclude pseudothrombocytopenia; if thrombocytopenia confirmed, discontinue therapy and heparin; previous exposure to a glycoprotein (GP) IIb/IIIa receptor antagonist may increase risk of developing thrombocytopenia

Pregnancy and Lactation

• While published data cannot definitively establish the absence of risk, available published case reports have not established an association with therapy during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes
• Untreated myocardial infarction can be fatal to the pregnant woman and fetus; myocardial infarction is a medical emergency in pregnancy which can be fatal to pregnant woman and fetus if left untreated.
• Lactation: There is no data on presence of drug in human milk, effects on breastfed infant, or on human milk production; however, the drug is present in rat milk; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition.